How much should you tell a therapist?

Do you wonder how much you should tell your therapist? What is it ok to talk about and what should you keep to yourself? Here are some guidelines.

1. The more you are able to talk about with your therapist the more likely the process is to help you.

If you feel the need to hold back on something you need to ask yourself why. Consider if this is something that might really affect your life or is it just embarrassing. You shouldn’t be embarrassed to talk with your counselor. They have probably heard it all before so they are not likely to be surprised. Their goal is or should be, to be helpful. They can’t really help you if you won’t tell them things that are bothering you.

2. Ask them about confidentiality

When you first came to meet the counselor they should have covered the rules and the limits of confidentiality. Some things are confidential, meaning the therapist won’t tell anyone else, some things are not. When you meet your counselor for the first time there is so much on your mind that you may not have understood it all. If you signed a copy of a confidentiality policy you should have received a copy. This is a part of the “informed consent” they are supposed to do. If you have any doubts about this ask them.

There are certain things that counselors can’t keep secret. By law, most counselors are required to report child abuse and the abuse of elderly or disabled people. If you have done something like that or know about someone who was abused, the counselor can help you by working on the reasons you acted that way. They should try to help you change. They can help you with the process of admitting what happened and helping the victim get treatment. If you were the victim of abuse when you were a child most counselors will not have to report that unless the abuser is still around and might be abusing someone else.

My suggestion to you is to ask the counselor about their procedures before you tell them something you might regret. This will give them a chance to explain the rules of their profession and the laws in their jurisdiction. Consider that even if there are consequences to you for telling it still may be worth doing. They say we are only as sick as our secrets.

If you are suicidal counselors are supposed to report this. Not to hurt you or take away your will but to try to save your life. Most times the client will report afterward that they were glad someone cared enough to prevent their suicide.

In most places, the relationship between a patient and their therapist is protected by law. So outside of specific things they must report, like child abuse, therapists are not supposed to disclose other things you talk about. They are not police investigators and they don’t have to report most crimes.

3. How much do you trust them?

The whole process of therapy depends on the trust between you and your counselor. Despite all the laws requiring therapists to keep things confidential, some people are not trustworthy. If you don’t feel you can trust your therapist– don’t tell them your secrets until you have resolved that issue. Now some of you have “trust issues.” You have trouble trusting anyone. Working with a counselor to learn to be more trusting should help that. So start by telling the counselor a small thing and see how that feels. You can work on the bigger things later on.

When I first started in this field I went to see a therapist. We are all supposed to have that experience if we want to understand how it feels for the client. The therapist should also work out their own issues in their own therapy, not in sessions with clients. I asked the therapist I was seeing if what we talked about was confidential. Their response was to ask me what I meant by confidential. They never did answer my question. So I avoided talking to that therapist about anything which might reflect on my future career. The lesson I learned was that if my therapist would not give me a straight answer about my questions I did not feel like trusting them. I make an effort to never do that to one of my clients.

P. S. I did eventually find someone I did trust to talk to about those issues and everything worked out just fine.

4. What is the consequence of this getting out?

If you might be embarrassed by a revelation say that you had a crush on some movie star when you were eight, even if the therapist did slip and tell your family you might be embarrassed, you might never trust that counselor again, but your life should not be ruined. If you cheated on your taxes or your wife and now feel guilty, having that revealed might be life-changing. Think long about telling your therapist where you buried the body unless you need them to help you confess that to the police and clear your soul. While therapists are not supposed to violate confidentiality and tell about clients past crimes sometimes it happens. When this happens the therapist loses their license and the client gets to feel really happy about that the whole time they are in prison. Neither of those outcomes is what therapy is supposed to be about.

The point of requiring therapists to keep clients secrets and to tell them up front what will and won’t be kept secret is to make it possible for them to discuss their problems without fear of reading about their issues in the local paper. Without that level of trust, most therapy would not be helpful. This is similar to doctor-patient or lawyer-client privilege.

5. Who do they work for?

If you want your counselor to keep the secrets you tell them within legal limits, then you need to hire and pay them.
If you visit a court-appointed therapist or one at the school or CPS they are working for the agency that referred you. They may have a duty to tell the court, CPS or the school what they think and what you said. They should be clear about this when you go to see them but if they are not – be careful and ask about confidentiality before you “spill the beans.”

6. Do they have a no secrets policy?

Some therapists, Marriage and Family Therapists and those working with children may have a no secrets policy. When I work with a couple I don’t want to be working on saving the marriage if I know that one of the parties is having an affair. I might tell both parties that I can’t keep secrets from the other partner if we are to work on improving the relationship.

This is a big issue when we work with children. Some parents want us to find out all the kids secrets. This does not work. After we tell the parent the first secret the child decides to never be honest again. This may require some balancing.

If an eight-year-old tells me they snuck a sip of dad’s beer or took some cigarette from a store and tried one, I don’t feel the need to tell the parent. I want to find out why the kid is doing this and work on that issue. What if the kid is injecting heroin into his arm? I think I should tell the parent that. So if it is life threatening I will tell the parent. I have covered this policy when I first start seeing the kid so he knows if it is life threatening or really scary stuff I plan to help him tell his parent but I can’t keep that secret. I do say that little stuff, the kind of stuff most kids do. That can stay just between us.

So there you have some guidelines for what to share with your counselor and when. Hope that was helpful.

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If the “victim” is over 18 it would not be an exception to confidentiality and it should not be reported. Sometimes in child to child abuse, it is difficult to decide if there was a victim or if it was consensual.

Would a prior “relationship” with a minor be grounds for reporting? A good friend of mine recently disclosed to me in confidence that he had sex chats with a minor (no pics), and mutually masturbated over the phone. The minor is now 18, but he feels horrific for what he’s done. He wants to go to a counselor to get over his feelings of grief – can he do this without fear of legal repercussions?

Assuming you are under 18, YES. Not only the school counselor but the teachers, the librarian, or the person in the cafeteria. Anyone working with minors becomes a mandated reporter and they must report child abuse.

You need to think about this a bit. Where did you see your Aunt-Counselor? At her office or in a home? How did you pay her? Cash? Billing medical insurance or was this free? Just because she is your aunt and a counselor does not make yer your counselor. In all likelihood, she was talking to you as a family member and no right to confidentiality attached to the conversation. You need to talk to your aunt about this. If she saw you professionally she may be required to make a child protective service report or risk losing her license. As a family member, she may want to talk with your mother. One worry would be if you are around the person who did the touching.Normally counselors do not do counseling with members of their own family or relatives because of problems just like this.

Probably not. Depression comes in a lot of varieties, all of which come in mild, moderate, or severe forms.Even mental health professionals have difficulty recognizing it by sight. Usually, it takes a full assessment, which takes a lot of time. Most school counselors are focused on behavior and grades. Unless the depression was extremely severe it is likely that the school counselor would not even know the student was depressed. The problem comes up a lot when diagnosing children. Does this kid have ADHD or was he up all night while the parents fought? School counselors don’t get the full story a lot of time. Mental health counselors can get it wrong even after doing a full assessment, especially if mom is sitting there and the child is afraid to talk about the problems at home. Do not count on a school counselor to identify a child with mental health problems. If you have concerns get them seen and assessed and mention your specific concerns.

Hello. I’m not quite sure how to ask this. So, to create a scenario, an 8 year child sometimes twisted her dog’s ears until he yelped. He’d then growl at her, so she told her family that the dog was being mean. It was blamed on him and he was the one to get in trouble. Fast forwarding several years, that child is now a teenager. She kicks/hits/shoves her dog (a different dog) to get him to stop barking. She feels terrible about it and is working towards being much nicer, but that same dog is still in her care. She is still capable of lashing out and hurting him.

While some of the animal abuse is going on, she seeks therapy for depression. The guilt of what she’s done weighs heavily on her. Seeing as how that dog is still living in her home, and the abuse wasn’t that long ago, would a therapist have to see to it that the dog is safe and in good hands? (Would it be reported?)

Lastly, would the dog be removed from the home if a report is made? The girl knows that she has problems, and she doesn’t want to act violently at all, but the dog won’t survive if he gets taken away. He (an overprotective pit bull) may very likely be put down.

I know of no place where harming an animal is a mandated or even a permitted report. There are lots of things clients do we wish they didn’t and there have been many groups wanting therapists to report various crimes, especially cruelty to animals. The problem with adding to the list of reportable events is it would keep people from telling their therapist what is really going on and then getting help to change that issue. As of now, therapists do not report any crimes. We only report intent to kill self or others or abuse of someone who can’t protect themselves. Please, check out the other posts on legal and ethical issues for a fuller discussion of that part.

You might start by talking with the school counselor or an adult friend that you feel comfortable with. I suspect your parents or caregiver know what you did, at least some of it. You might talk to them about getting into some counseling.

My problems may be a bit out of the ordinary, I am young, Younger than 16, and I struggle with anxiety and depression, and I don’t know if this counts as self harm but I always hold ice in my hands because it stings, but that’s it. and my past is not helping, I was the bad guy, long story short I got bored and eventually attention seeking and started lying about my past and even people I know to my friends online, I lied about things that are illegal that never happened, most of which real things that I exaggerated so they would sound either illegal, suspicious, or just incredibly strange, every lie was well thought out, even occasional pictures I faked to make shit more believable. Now I’m someone who never went outside during that period of time, so this didn’t help. Now, a few months into the future I realised how bad all of that was and have turned who I am around, I came clean about my lies to most of my friends and then cut ties with them and deleted my accounts as I no longer wanted to worry. And now, I recognise what I did completely, I get sick just thinking of the stuff I lied about… I never want to even think of that shit again and I hate lying and talking about anything violent now, I am repulsed by it, I just want to make people happy, I want to make the world a better place, I want peach and understand the shit I lied about are real major issues and I want them to stop. I am wondering, if I tell my therapist all of that, will anyone need to investigate? I simply do not want good innocent people I made lies about and possibly twisted into looking bad to get in trouble because of some dumb disgusting little kid.

From your description here I don’t see anything that would require a report. If I were seeing a client such as you describe I would want to talk to them about the holding of ice and suggest some other ways they might regulate their emotions. By self-harm were usually talking about trying to kill yourself or doing something that could result in permanent injury. I would suggest finding someone you can talk to about this in an honest fashion. Try not to be too hard on yourself for the mistakes you made in the past, but try to learn from them and make every effort not to do those things again in the future. One way of looking at this is, try to stop looking over your shoulder at the past, and spend your time looking toward a positive future.

Thank you so much! Your response actually really made me feel quite a bit better about the situation, and that I can trust anyone I talk to about the situations ko e than I thought I could, I will try my best to stop focusing on the past, and will try and stop worrying. Thank you, everything you do on this website is really helpful and kind of you! you are improving lives.

Let me see if I can explain this. The mandate is to report abuse, not crimes. Three possibilities here.
1. A minor or disabled person can be the victim of a crime which is not abuse. Someone breaks into their home while they are gone and steals their PlayStation. They are a victim of a crime, but I doubt this would qualify as abuse.
2. Some abuse may not be a crime. Parent or caregiver calls minor fatso, stupid, and constantly puts them down. This could be abuse but probably is not a crime in most jurisdictions. In some places, child protective services might intervene to try to get the parent to stop. Emotional abuse could be reportable even if it is not a crime.
3. An act could be both abuse and a crime. The abuse part of this is reportable.
So to your question about a disabled person. Once a child turns 18 they are an adult. They are now responsible for making their own report. At this point, the therapist stops reporting.
Since most disabled people will never stop being disabled, the counselor would continue to report this regardless of how long ago it happened. For many kinds of abuse, there is a statute of limitation. If the disabled person was abused 30 years ago, I doubt any law enforcement could prosecute this crime. For the counselor, I believe, even though it is no longer a crime which will be prosecuted, we would still report it. It is the fact that it is abuse that makes it reportable. Not the possibility that the minor or disabled person was the victim of crime. Hope that helps. When in doubt, it pays to check with the lawyer in your jurisdiction, and someone who can consult with you about the code of ethics of your profession.

I had an affair 15 years ago
I accused my wife of having an affair recently
I got a little angry about her behavior
getting calls, texting hiding her phone, taking it everywhere, staying up late
excuses where she was, always shopping, but bring home the same bag.
things were off. Her responses were short, but made little sense
they put me I therapy
they said I had anger issues
and the therapist told me I checked out of my relationship
along time ago.
my wife became distant.
She was always tired when I came to hug her.
NO time for me, no intimacy.
The therapist asked me why I was paranoid.
My wife sees him now.
he has not asked me back
help

Sounds like a very difficult situation. If you had a good connection with the therapist you should probably make another appointment. Not sure why the therapist would ask you back. Ideally, you and your wife need to talk about these issues. Consider making an appointment with the new therapist so that both of you could go together for marriage counseling.

Hey. This is kind of an odd question, but it’s a serious one, and I can’t seem to find an answer for it anywhere. To start, I will describe a scenario. Lets say that a 13 year-old girl begins talking to a 39 year-old man in a chat room. They form a relationship together. Without going into any details, personal pictures were sent/received, and they’ve taken their clothes off in front of a live camera. The girl is 16 now and is seeing a therapist for a number of reasons. She continues to talk to that man and they still do sexual-related things sometimes, even though the age of consent is 18 in her state. It is 16 in the man’s state.

…If she tells the counselor about this, will that counselor report it? Given that it is a crime involving a minor and an adult? Or, will the counselor maintain confidentiality at all times?

I should mention that she isn’t a licensed therapist YET. When explaining her confidentiality rules, she said that she may tell other counselors in the building about things that her clients say (to get feedback and opinions on it). She also said that the client’s name will be used during the conversation. So, I have one more question. When she does get her license, will she no longer be able to share information with the other counselors in the building? You don’t have to answer that if you are unable to, but I’d really like to know.

Lots of legal questions here. Those would depend on the laws in the jurisdiction you’re in. Age of consent is irrelevant. The issue in counseling is mandatory reporting. In California sending and receiving child pornography would be reportable as child sexual abuse. Not sure about your counselor discussing it with other people. If they are a counselor in training they are still mandated reporters. Licensed or not counselors can consult with other counselors in their agency. Given you being under 14 when it started, that there sounds like child pornography involved, and that the man is more than 10 years older than you, this sure sounds like reportable child sexual abuse to me. It’s likely that you sending out sexually explicit photos of yourself constitutes creating and distributing child pornography. You could end up having to register as a sex offender. My recommendation is to stop doing this and to clarify confidentiality with this counselor. Sorry for the slow reply. I think you present a serious issue here that ideally needs to be discussed with an attorney.

Thank you for responding. I thought you had skipped this question, because it didn’t notify me.

A few months ago, I did ask my therapist to go over the mandated reporting laws in more detail. (I didn’t want to specifically ask her about the question at hand, so I listened as she explained other topics like suicide and went down the list.) She then said, “I am mandated to report any sexual relationships between an adult and a minor.” That just about sums it up, I would think.

Side note: Could I really be labeled as a sex offender for taking pictures of my own self? This stopped occurring over a year ago, and I have no intention to do it again. The law can vary from state to state, so I will say that I’m from Oregon.

Since asking this question, I’ve decided not to tell her at all. I will be 18 in a little over a year. She said that reporting is no longer mandatory after that, so I will wait until then. It isn’t worth getting myself and the other person involved into trouble.

Taking pictures of yourself probably no problem. Sending them over the internet could be a big problem. Here in California that would be reportable as child pornography. Even after you were 18 you could still be guilty of distributing child porn. Most young people have no idea how potentially serious and life changing this can be.

I think your question was:
“Side note: Could I really be labeled as a sex offender for taking pictures of my own self?”
Answer – Yes, not only labeled, by arrested and convicted and sent to jail for distributing child pornography.

Absolutely! If this is a psychiatric hospitalization the therapist can help you work on the reasons you were hospitalized. For physical hospitalizations the counselor can work with you on the emotional issues. Thanks for commenting.

I just turned 20 I have a therapist and we are getting close with the whole trusting each other process, and I want her help to process through when my friend and I got a train ran on us by a couple of guys. I don’t want to report any of it, I just want help processing through it so to say… I’m wondering because of my age if I tell her don’t want it reported, does that stop her from reorting it. It’s from a year ago so its not that old

I am in therapy, and I am interested to know if I reveal that my step sister (14yr) is currently being physically threatened and emotionally abused, does my therapist need to report that? She is definitely safe with food etc., and I suspect foster care will be worse for her and she is still attached to her dad.

Sometimes it is a judgment call to decide if something is really abuse. If the child is being abused, yes it’s a mandated report for a therapist.In the situation you describe I think there’s a very low probability that the child would be placed in foster care. There just are not enough foster homes for the serious cases involving sexual and physical abuse. Even if the authorities get involved they are likely to make the parents take some classes or go for therapy. If you’re really concerned about this child, you can make a report yourself or discuss the situation with your counselor. Thanks for commenting.

I am interested to know the definition of “others” in this context. Do animals count? For example, if the client reveals that they have been killing dogs will they get reported? Or do “others” only mean humans?

I do not believe that others applies to animals. There been lots of efforts to expand the things therapist have to report, cruelty to animals, statutory rape, bullying, immigration status and all sorts of other issues. The basic rule is everything is confidential unless you can find a specific exemption in the licensing law. Creating too many exceptions would keep people really need help from ever coming from counseling. I do not see an exemption related to non-human animals in the California law. The someone is having a problem with wanting to hurt animals I hope they get the help they need. Hope that answers your question.

I’ve been encouraging my brother to open up more in therapy. Our history is long and twisted, but from what he has said, I believe that he has molested a child before. I absolutely don’t think that he is a danger now, as his behavior has changed entirely, but I think he still punishes himself for it. I don’t feel super-comfortable getting him to open up to me, and I don’t think I’d know how to help him anyway. He is a legal adult now, and I don’t want to encourage him to open up if it will mean judicial punishment or anything else involved. He has punished himself enough already. I just want him to get help, but I don’t know if this is the right way to do it.

Thanks for contacting me. I’ve had the blog set to auto pilot, publishing prescheduled posts while I’m away, so it’s taken me a while to get back responding to some comments and questions.
If the child he molested is still a minor, then it would be reportable. I would encourage him to get help so he does not molest again even if he is not willing to give the details of the past incident.

I’m 25 yo and just started seeing a new psychologist. I told her about how my parents use to abuse me both physically and emotionally (6-10 years ago) and that there’s no children in the house now. I also told her that I’m on speaking terms with my parents and my dad and I have a good relationship now. Is she required to report that or no since I’m over 18?

The general rule would be that once the client is over 18, it would not be reportable. The only way something would become reportable here is if you said something that indicated that a child was currently being abused. Thanks for commenting.

I am not sure what the laws would be in the uk. Maybe someone from there will trad this and add to what I say. Most professionals could expect to report abuse of a disabled person. Emotional abuse is “ify” What one person considers emotional abuse might not bother someone else. Raising your voice might feel like yelling and be abusive to someone with PTSD. Yelling at players on sports teams is common. So yelling may or may not be emotional abuse. It is the impact it has on you. I suspect that if you describe this as abuse and the counselor agreed, it would get reported.

I am 18 years old from NJ. I’ve been seeing a therapist for two years now and have been hesitant to bring up something I did. I stole money a couple years back when I was 16 and I feel extremely guilty about it. I want to talk to my therapist about it but I am unsure if he is liable to tell authorities.
Do you think my therapist will be required to tell authorities about this?
Thank you and any response would be appreciated.
🙂

I do not think any therapist anywhere would tell about this unless there is something else involved. As long as they are not court ordered to report or a child was not involved not likely they could tell let alone would.

I turned 17 a few days ago (August 6th) and I had consensual sex with a 22 year old whose birthday was also a few days ago (August 4th.) I currently live in Wisconsin and he currently lives in Minnesota but is moving to Wisconsin in a few weeks. If I were to tell my therapist about this, does she have the ability to report this to the police? I haven’t been 100% clear on the consent laws in Wisconsin but I know in Minnesota it’s 16 or 17. I was in no way coerced or forced into having sex. I do want to talk about it but I will not risk telling her if it’s going to get him in trouble.

Sorry for the slow response. This sounds like a question for a lawyer. Each state has different laws and then you threw in people from two or more states. What I usually suggest, short of talking with a lawyer is to ask the counselor what they report and then decide what you want to tell. I see this as illegal, probably statutory rape but not reportable as child sexual abuse. I do not think most therapists would report this as it was consensual and you are over 16. But people do not always do the right thing. Eventually you need to talk about what happened. I would hate to think you would need to wait till you are 18 to be able to talk about it. Best of luck and thanks for commenting.

A close friend of mine just put herself into drug treatment a little over a month ago but is very distressed about telling her new counselor about her past drug use, which included some illegal activity to maintain her addiction. She very much wants to be honest about it, but fears repercussions if she tells her counselor about it. I want to help her but I’m not sure how to comfort her about it. Is the counselor mandated to report illegal activity with past drug use?

Counselors are prohibited from reported past illegal activity unless it is a mandate report as in abuse of a child. Believe me anyone who works with people in drug recovery know most of their clients have done things that were illegal. Tell your friend not to worry about being honest.

Depends on what you mean by “self-harming yourself.” If you were currently trying to kill yourself, they would make the call and try to get you emergency psychiatric help. If you used self-injury as in cutting or burning to regulate emotions, they should work with you on other ways to manage emotions. Some self-harm falls in a gray area and it may scare the counselor. Even when the client does not mean to die some self-harm is so dangerous it may result in death. In that case I think most counselors would make the call and get the client medical and emergency psychiatric help. Two factors matter: your intent and the seriousness of the self-harm.

what if i tell my therapist i’ve been a frequent marijuana user for the last two years especially the last month, and have been on xanax for a couple of days that led to me to this point of seeing a therapist because i came home high? and had unprotected sex (twice maybe)? and i used to steal? will they tell my parents? by the way, the things i stated above are just the starters.

Lots of maybes here. Partly depends on how old you are, and where you live. If you are relatively young and the person you had sex with was a lot older then that part might be reportable as child sexual abuse. Your age would also determine your ability to give permission for counseling or whether you would need your parents consent. My recommendation is for you to ask the counselor what they would need to tell your parents and then see if you feel safe to disclose. Even if they believe it needs to be reported the counselor should help you do that in the safest way possible.

Hello,
I am 27 y.o F from Michigan. I am debating to see a counselor for a number of reasons. My question is does my therapist have to disclose information about my childhood molestation. It has been over 11 years and I have no contact with this person. My family members are aware of it, but due to cultural reasons, its been talked about and brushed under the rug. I feel like with my recent problems, its important to bring that up, but again I am worried about it being disclosed and have to go through the trauma again. Thank you for your time.

Once you turn 18, no things that happened to you as a child should not be reported by your counselor. You are an adult now and confidential info can not be disclosed unless it meets a legal exception to confidentiality. The only way it would become reportable now is if there is a child being abused now.

My partner is a psychologist who is a colleague with my psychiatrist, & I have admitted some past illegal drug use to my partner who is a psychologist. I am currently actively in drug abuse treatment counseling. Does my partner the psychologist have a moral and ethical responsibility to tell my psychiatrist of my past drug use? Would there be any negative or professional implications if he did not disclose this information?

Therapists have to maintain confidentiality unless it is a mandated exception. Past drug use over 30 days makes it substance use disorder in early remission, over a year is in full remission. Generally these confidentiality and exceptions requirements only apply to clients not family and friends. I do not see any reason that your partner needs to or is required to disclose communication from a partner. I am not familure with psychologists code of ethics bur that should not apply here.

Great advise and helpful for most. For me, telling all didn’t help. The therapists didn’t like what I said. They also chose to not bleive me. Why would a 45 year old wife and mother who wants help, who is responsible and dependable and sharp lie in therapy? I’m the pson who has kept neighbors key if they have an emergency, the one who babysits for people’s kids, also if they have an emergency. So why wold someone choose to think I lied to her?? Many people don’t understand each other. Sad when you pay for this treatment!!!

Sad that a professional would think that a client is intentionally lying. Someone who is forced to therapy but does not want to be there may mislead the counselor but then the therapy is not likely to be helpful. Sometimes I have clients tell me things and I know they believe it but it does not seem likely to be true. To be helpful I need ot understand why the client thinks of feels that way. Sometimes it is easier to think the client lied than to admit we don’t know how to help them. I hope you find someone to work with that can be more helpful.

I recently received my second D.U.I. and am going to substance abuse rehab for at least three weeks in April. Until then, I want to pursue individual counseling for a special concern I have; my multiple sclorosis. I’m waiting to hear if a neuropsychologist is going to admit me to her program but I also want to pursue family counseling. My ex-girlfriend and I have a 4-year old son but she just got engaged and doesn’t want my help. My son witnessed some domestic violence in the form of yelling and slapping, but that was 2 years ago. I guess my question is how can I convince my ex it is beneficial for my son to see me and maybe participate in family therapy?

Very hard to convince someone else of something. You have a second DUI. Pretty clear that sometimes when you drink it is a problem. My suggestion is that this all takes time. First work on yourself and all your issues. then work on being a part of your sons life. You and your former girlfriend may or may not ever talk about anything again other than your son. Keep working on your life and see what happens.

Hi! I’m noticing you still respond to a lot of these comments, so maybe you can help me out. I am 16, and I recently asked for therapy. Here are several things I want to know about confidentiality in. I live in NC if that helps in any way. And when I say reported, or confidentiality, I mean, will the therapist tell my parents.
1. Self harm. I am not in any danger when it comes to self harm. I already have several adults who know about it and can help me out at any time. I even know an EMT who can patch me up if I really needed it. I don’t want my parents to know. Specifically my mom, She simply isn’t strong enough.
2. Substance abuse. I smoke weed on the regular, and I drink a lot when I hang out with my friends. Since hanging out with my friends is a big part of my life, I want to know if I can be honest about that part of my life. Smoking and drinking aren’t things I think I need help for, and they aren’t endangering me in any way. I simply see it as a phase.
3. Past abuse. Abuse from when I was very young, or when I lost my memory. We’ve since moved away from those places, those people are no longer an issue. If the person is no longer in the picture, and no longer near where I live, will my therapist tell my parents?

I’m beginning to regret my decision to get therapy. I didn’t realize on how many topics a therapist could break confidentiality. And most of the things I desperately need help with are the ones that will go back to my parents.

Thanks for commenting. Sounds like you have things you need help with. You probably need to get clear what it is you want help with. The more you can be honest with the counselor the more likely it is they can help you. Say you are failing in classes and you see the counselor for help with that. The fact that you are smoking weed is affecting your memory, past traumas may be impacting your learning also. The counselor needs to know that stuff to be effective in helping you with your studying. You thinking that your mother is not strong enough to hear something is concerning to me also. If so, she needs help also. Your counselor may be able to arrange that if they know the situation. I would discuss your concerns with the counselor and what they feel the need to tell. Yes, since you are still a minor if you report abuse this will legally need to be reported. How the agency in your area handles this I can’t tell you for sure but you can ask your counselor before you disclose the details. One thing to consider, if someone abused you, they may still be abusing other children. Your speaking out, ever though it is difficult, may prevent the same thing happening to another child. Hope it all turns out well for you. The younger you are when you deal with this stuff the more happy-life you are likely to have. Best wishes.

im 13 and should i tell my counselor about my parents drug abuse because that is basically the only reason i got into counseling. my mom told me not to talk to counselors about it because i will get took away but i dont know what to do anymore. i am tired of dealing with my mom and supporting her drug habits

Hi Gloria.
Sounds like you have a difficult situation there. Since I am not there and don’t know you I can’t give you specific advice. Hopefully you have a good enough relationship with your counselor that you can talk this through with them. Just because a parent does drugs does not automatically mean a child should or will be taken away. Sometimes the thing that gets a parent into treatment is the pressure of losing their child. If this is as difficult a situation as it sounds then I think you need to tell the counselor what is going on and see if they can help you help your mother. Addiction is, in my opinion a disease that does not get better without treatment. Unfortunately not everyone with an addiction can get clean. Hope this short answer helps you in some way and that you can find someone close to you who can help you get through this.

I’m 15 and I’m thinking about seeing a therapist, I basically know where most of my emotional problems stem from, and all I really want is someone I can trust to tell about these things and these problems, without weighing my personal friends down. The problem, is the root of my problems may be something that could make the therapist break confidentiality. Basically, an adult in my life has a substance abuse problem, they’ve never really gotten physically violent, it’s more of a mentally abusive relationship and I would need to tell my therapist about this adult, but I need to know if they’d get authorities involved, because to outsiders it seems like there’s a pretty big chance for physical abuse, but I know there isn’t a real chance for physical abuse, otherwise I’d have told someone. I kind of understand that they won’t tell about me, but there are two more minors, one who has experienced what I have mentally and another who may end up growing up by themself and having to deal with the mental abuse on their own. Would the therapist have to tell someone about this if they thought there was a chance of physical abuse, even if I assured them there’s not?

P.S. I know I was kind of vague with gender and other details, but I don’t want to go into too much detail.

From your description I am hoping you get the help you need. It is not just physical and sexual abuse that gets reported but emotional abuse also. Yes it is possible that this would get reported. Sometimes getting the authorities involved can be just what the person abusing substances needs to seek help. You also need to consider the effects this may have on a younger person when the rest of the family is gone and they are alone in a possibly abusive situation. Look for someone you trust. Get to know them and then see if they cant help you work through all of this. A good therapist should be able to help all the family members involved.

I’m 19 20 in June I’m in new Zealand I am currently seeing a counselor and I was abused in my younger years must of been at least 10 yrs ago now the person is no longer around if I tell her am I able to refuse her to tell anybody including law? or is there a way I can tell her that she can’t say anything like if I don’t admit it is there a way around it I need to tell her as its making my life difficult

Not sure about the laws in New Zealand. You would need to ask someone there. In the U. S. and most other places, you are over 18. After 18 you are not a child. No report. Counselors do not report crimes. They only report abuse of a child to prevent the child from being further abused. If you do not give details, who and when, there is not much to report. What is important is to work through the trauma, not to go into all the specific details unless that is important to you. You can always ask the counselor to tell you first what they are required to report and what they do not. Hope you get the help you need to get better.

What if an adult patient enters therapy and it becomes a sexual relationship that continues in therapy. The therapist many years later has to leave the the practice so the patient now needs a new therapist. The patient wants to talk about the years of what has occurred not to file any law suits ever just to deal with the emotional pain. but would the new therapist be obligated to report this?

In California the new therapist would NOT be able to break confidentiality and report this. They are required to give the client the book or pamphlet “Professional Therapy Never Includes Sex.” It is up to the client to decide if they want to pursue an action against that therapists license or a legal action. I would suspect the rules are very similar in other places.

I am 15, and currently seeing a psychiatrist. I don’t tell her that I am currently self harming or that I was sexually abused on New Year’s because I am afraid both of those give her a reason to break confidentiality. I would like to be admitted into a psychiatric facility for a short span of time or at least until some paranoia and other symptoms go away. How can I go about being admitted without telling her about self harm or abuse or suicidal thoughts ect.?

Not sure how to help you here. It is hard to get into a psychiatric hospital these days and it is expensive, thousands per day sometimes. You will only get in if you have some very severe symptoms. Once in you will not get out till the symptoms get better. You will not get to chose, the staff in the hospital will make those decisions for you. My suggestion is to be as honest as possible with your psychiatrist and let them help you.

What about a therapist telling a client something they should not have. This was not what I wanted to here. It looks like there’s a trend towards therapists disclosing more but some things are just way too much to hear.

Not sure what you are referring to here. This might depend on whether this information was about them or about you. If all therapists did was listen, then you could get that advantage from talking to a dog or cat. We should model health behavior and it is not health to have someone who always agrees with you about everything so sometimes we need to let you know that not everyone would agree with what you are saying.
I think counselors need to give people feedback. Unfortunately sometimes we have to tell clients things that they do not want to hear. Say they are telling us about doing something and we tell them that as long as they keep up that behavior they will not get their children back from Child Protective Services. If your therapist has talked about something that made you feel uncomfortable then talk with them about this and see if this is something they shared trying to be helpful or if this is something they really feel you need to face. Hope everything works out for you.

This is something that I’ve been curious for awhile. I saw my previous therapist during most of my childhood. He, I believe was a family therapist, and there seemed to be zero confidentiality between us. I don’t even remember this man telling me that there was a law for confidentiality between patients and their therapists. At the end of each and everything session my family would be called in, sometimes I was told to manual do this and once everyone was seated he would proceed to tell them everything that was said between us! I didn’t like this and I was lead to believe that this was how all therapy sessions were. I didn’t find out about the law until about the last or second to last year of me seeing this man. Besides this, there were many times where he tricked me into saying things and accused me of terrible things like me and my friends being drug addicts, which wasn’t true, and me accidentally telling him that I was suicidal in the past. He tricked me into saying that las bit because 1. I felt that I wouldn’t get the diagnoses I believed I had at the time and 2. because he promised that it would stay between us. However, I soon as I told him he did a 360 and told me that because I was a minor at the time that because of the law he HAD to tell my family. I panicked and desperately tried to get him to understand that he had misunderstood. He tend told me that he wouldn’t tell them, but I was betrayed again because as soon as they were brought in he told them and as well as told other lies on me. I am wondering if what he did was illegal.

Complicated situation and this deserves a full answer. Unfortunately in the space and time I have it will have to be a brief one. The legality is an issue for a lawyer. Your description does not sound like the process was as helpful for you as it should have been. One factor to consider is the age you were at the time. The younger the child the less the child will understand the whole issue of confidentiality. One thing this therapist should have been doing is helping you be able to express your feeling and what was going on with your parents. This should not be done as prying out the secrets and telling them but as helping you feel confident to tell your parents how severe your problems really were. He may have explained the requirements of confidentiality and what he was required to report to your parents but that information was not passed on to you, or if it was you did not catch the significance of this. The sick person in the hospital does not usually understand what the doctor is trying to explain. The circumstances also would depend on what the therapist thought your “diagnosis” was. Someone will severe impairment may need a different approach than someone who is bright and high functioning. You sound older now and wiser. I hope that you do not let a bad past experience deter you from using counseling or any other form of help for your emotional problems. Now that you know more make sure to ask more questions upfront and if you do not feel comfortable adjust your behavior accordingly. Hope that helped answer your question and thanks for sharing your comment with the rest of us.

I’m a minor, 15 in New Jersey. I regularly talk to the counsellor in my High School about my life and what not. If I tell her about PAST experimentation with prescription drugs does she have to report? What if I tell her I have no intentions of moving forward with taking drugs? Which I don’t. I don’t want any problems whatsoever but I want to get it of my chest. By law must she divulge this information to my parents? What about to authorities? It is considered theft I guess. I’m a honor roll, intelligent charismatic kid and I really don’t need problems over things I tried. Thank you.

You probably need to ask the counselor you are seeing what things they will tell your family and what things they will keep confidential. Many school counselors here in California are not licensed and while they had some training in law and ethics their requirements are different from those of a licensed Therapist or Licensed Counselor. They may have the added duty to tell the school administration if things you did in the past could involve other students or activities on school grounds or on the way to or from school. I have no idea about the laws in your state. The school counselor may also have a requirement to tell your parents certain things. Ask first in a general way and if you are uncomfortable with the answer find a person you can trust to talk this through. At your age you probably need your parent’s permission to see and outside therapist. If you have a religious faith consider talking to someone in your faith or telling God (or your higher power) about this and see if that is enough to clear your need to tell. Hope that helps.

I’m 15 and I live in Alabama. I want to go to therapy to deal with sexual abuse that I suffered when I was young. The perpetrator is not a danger to anyone else now. I do not want to report this to police, but I do want to work through it. My parents know everything, by the way.
Thank you so much!

In case it helps Pedophile is not the same thing as child molester. A huge number of women have been molested as children and it is extremely rare for them to go on to molest anyone. A counselor can talk you through all of this. Absolutely you should talk with a counselor and unless you act on those urges there is no reason for the counselor to report anything. Best wishes on getting over your past and your fears.

Hi,
I was recently reading about OCD and sexual thoughts. If a person was experiencing obesssive thoughts that they will act out sexually towards a child, and shared that information with their therapist what would happen to them?

Never having acted on them, and completely disgusted by them but they are still there.

Thoughts are not acts. The therapist is prohibited by confidentiality laws from disclosing that clients thoughts to anyone else. A good therapist would want to work with the client on ways to avoid acting on those thoughts and possibly a safety plan if they become concerned they will act. Who will they call, what will they do, and so on. Lots of people struggle with thoughts for many years and never act on them. Being afraid they will act on those thoughts sounds like a good thing because they are working on controlling themselves. The point of keeping this sort of thing confidential is to allow that person to work with a therapist on reducing or controlling those thoughts. Hope that helps explain the process. If some one is having those sort of thoughts I would urge them to talk with a licensed counselor.

I’m a mom, I know deep down I am a good mom but I don’t think I believe it as much as I know logically. I have obsessed about being a phedophile since I was molested, and for some ungodly reason, told that “phedophiles were usually abused as children.” This to me translated to, “you will probably become one.” Even though I know that isn’t at all what they meant.

Now that I have a child I am even more obsessed that I too will become a phedophile. I know I should talk to my therapist, and I do believe it would help. I am just TERRIFIED of losing my daughter. I would have no reason to live without her.

Thank you so much for responding right away. I know I need to speak up; I’m just so scared of what I have to lose. Also just to be clear, I have never acted on them or even thought at the action, just the thought that I could. If that makes sense.

So a not so friend of mine had sex with a minor, my daughter. He was 24, she was 16. It has been 2 years since I last heard from him and he asks me if he can talk about this to a therapist. He was a close friend of mine and I care about him. I encorage him to seek help and my daughter and I did not and still do not want to press charges. So my question is this, will his thrapist report him for this crime?

Laws vary a lot so I can not be sure about the laws in your area but here is the basic idea. Counselors do not report crimes. If we did not one would be able to tell us much of anything and then we could not help people who have done something wrong in the past change. We do report child sexual abuse. While sex with a 16 year old is a crime (statutory rape) in most places it is not child sexual abuse. A 16 year old is supposed to know enough about sex to be able to say yes or no. Child sexual abuse laws, as I understand them are meant to protect the weaker from the predator. So in Californian we have some extra protection for children when the “perpetrator” is at lest ten years older than the “victim.” Children under 14 get extra protection.15-16 year old get a all little less protection and over 16 get less protection yet. The only exception to that would be any age retarded or disable person may get extra protection.
FYI laws in some places are different depending on the sex act. Vaginal intercourse is less likely to be reportable child abuse than anal or oral. As a counselor I don’t need those details unless this is sounding like reportable child abuse. This is not sounding like reportable child sexual abuse to me but it could be a crime (statutory rape) if someone wanted to press charges. Not sure it that answered your question but for more details you need to ask someone in your legal jurisdictional, a lawyer or therapist.

Rules may vary from place to place but generally the answer would be no. What you may be talking about is deliberate self-injury sometimes called cutting. I have had clients who rage all the way from scratching their arm with a paper clip to serious deep cuts all over there body. Most cutting comes from deep emotional pain not a desire to die or really harm themselves. Unfortunately some people who cut get carried away and cut to deep and could bleed to death or get infected. Sometimes people who cut also become suicidal and that has to be reported. A good counselor should want to know a lot more about why and how risky this is before deciding if this meets a criteria for being reported. This gets problematic if the self-harming person is under 18. Then the counselor may want to put a plan in place to keep the person safe and therefore will need to tell the parent or parent. Also some kids, but not all, who cut are being abused or neglected in some way. That abuse or neglect is reportable if the victim is a child, senior or a disabled person.
Some people think that counselors should report or try to stop any dangerous behavior. Doing drugs or driving drunk is risky behavior. So is unprotected sex. Most of the time counselors try to help the client through the pain but do not report the behavior unless there is a legal mandate to do so. If in doubt ask the counselor what things they have to report and what is confidential. Remember also that if you pay there is more of a relationship. School counselors may have to report more things than those in private practice.
I hope that helps a little. I encourage you talk this through with a professional who is willing to help you with whatever your problems are.

I am 15 and i live in Indiana. I have a history of alcohol use, self-harm, a violent past that nobody knows, and suicidal thoughts. Would i be able to talk to a therapist without them telling my parents anything? Like not even telling them that i went there?

With that list of problems Charlie I strongly believe that you need to seek help. Without help those problems will only get worse. With counseling it is very possible for you to live a happy positive life.
I am not sure about the laws in your state. You would have to ask a lawyer or counselor in your state about that. Another question that comes to mind is your parents. Do they care? Would they care if they knew? A counselor might be able to help you tell them and set up treatment that they could agree to.
If you have been abused in any way that will get reported to the authorities in most any place I know of. If you are currently suicidal then any professional will follow the procedures for notifying authorities in your area. Those authorities will have to talk to your parent.
In some places you could talk to the professional without telling your parents but then you need to pay for the counseling or see someone that will do it for no fee. At 15 the standard for you consenting will probably be very high. You need to think you are in danger, but then they will need to do anything and everything to protect you.
That past violence stuff does not need to come out until your get a working relationship with the counselor established unless you have been the victim of the violence and the person who did it was an adult.
I can’t do counseling over the internet but I would urge you to find an adult you can trust and talk to. That might be a school counselor, teacher, religious person or even someone at a boys club or mentoring program. You might also be able to walk into Children’s mental health or a mental health clinic in your area. Also check your local listings, there should be a local A.A. or N.A meeting and some of those meeting have a teens or young people’s meeting. If you are old enough to drink or use then you are old enough to go to meetings.
Please keep looking for help because I can promise you that it can get better.
If there are any readers in Indiana who can hook this kid up, please leave a comment with suggestions or numbers he can call.

Thank you for the advice. And im afraid my parents would treat me differently if they knew and i dont want the way they treat me to change. I havent been abused in any way. The violent past was with teenagers when i visited Illinois for 3 months. It’s all said and done now. My school counselor tell parents everything in a situation so I’m crossing that off my list of where to turn to for help. And thank you again for the help. Very much appreciated.

Maybe yes. Maybe no. Counseling and psychotherapy is all about the relationship. Once a counselor reveals something about a client to someone else that relationships is probably damaged, maybe irretrievably. The professional should have told you at the beginning of counseling what they would tell and not tell. Personally, whenever possible, I would discuss the issue with the client before I made that call. Sometimes I even encourage to client to make the call to law enforcement or Child protective services themselves and I sit by while they make the call or have them listen while I make the call so they know exactly what I said.
Reasons why a counselor would disclose something to someone else and not tell the client would include a potentially dangerous client. If they plan to go home and kill someone I would first try to talk them out of this. If that does not work I might wait for them to leave the office and then make the required and permitted warnings to the intended victim and law enforcement. If a child victim is involved I might also not tell the client to try to protect the child.
Here in the U. S. potential terrorists do not get confidentiality under the patriot act and we are not allowed to tell the client that homeland security came around to ask about them. I do not know if this has ever happened as I don’t think terrorists go for therapy very often.
Past crimes do not get reported unless child abuse was involved.
The sticky area is minors who tell the counselor something and then the parent wants to know. Parents can get awfully demanding, wanting to know what their child says and the laws can get extremely complicated. I prefer to have a discussion with the child, the parent and me all in the room together before we ever start therapy. That way we all know up front what will be told and not told to the parents. This still does not keep the child from trying to tell me something and asking I keep it a secret from the parent or the parent changing their mind and demanding to know something.
Most common parent questions are 1. Are they having sex? 2. Are they doing drugs? If the parent is asking the chances are the answer is yes and so a better question is what we should be doing about this activity.
Hope that helps you. The laws and customs in your area may be different. Ask your counselor for more clarification if you are not sure.

i will be 18 soon, like, in a couple weeks, so disregard my current state as a minor. will my therapist have to report any of the following if he is informed once i am a legal adult?
– past sexual abuse (during teenage years)
-self injury addiction (without suicidal intent)
-any drug or alcohol use?
thank you very much! (i live in ohio, BTW. we have most of the ACA rules are actually laws here.)

Some general answers here. I am not up on laws in your state. One major factor is who is paying for your therapy and why you were referred. If it is court ordered then probably the drug abuse or results of any tests will be reportable. You should be asked to sign informed consent and releases when you turn 18 if you have not done so already. You should probably ask the counselor to explain the rules of confidentiality and how they have changed since you are now 18 before you go any further.
Generally past abuse is not reportable if you are an adult when the counselor learns about it. The exception to that would be if you know of other minors that same person is abusing. Then that abuse of other minors will get reported. Counselors are mandated reporters in most places. The client is not. Clients or private citizens can make anonymous reports in most places; a mandated reporter is not allowed to make an anonymous report. They need the proof they did what the law required.
Insurance companies need the diagnosis for payment. So they might get something like 309.81 Post-traumatic Stress disorder 305.20 Alcohol abuse. That’s all the details they normally get.
I do not know of any place where non suicidal self-injury is reportable unless the injury requires emergency medical treatment. If you are bleeding to death the counselor will call an ambulance to keep you from dying, that is about the only thing they are likely to do.
If you are in a drug and alcohol treatment program voluntarily you get an even higher level of confidentiality under 42 CFR than a mental health client gets under HIPPA (45 CFR) unless you were court ordered to the drug treatment.
When in doubt ask the counselor to explain confidentiality. If they can’t or won’t explain it to make you feel comfortable consider looking for another counselor. Hope that helps.

Your comment raises some really important questions. Who goes to the hospital and why? What are the rights of a minor in treatment and can you expect confidentiality or will the therapist tell your parents? Sometimes a person under 18 can seek their own treatment and sometimes they need their parents’ permission. Since I don’t know you, your parents or your therapist I can’t give you specific advice or treatment. I think your questions will interest others also so over the next few days I want to post some things on this topic. Since you are currently seeing a therapist I suggest you discuss the issue of what they will tell your parents and what they can keep confidential with your therapist. But if this is an emergency, if there is any chance you would hurt yourself or others I would urge you to tell the therapist and let them help you and then let them help you with your parents afterwards. Watch for my first post on hospitalization coming soon.